Application To Be Added To The RESNET Directory Of Individuals Who Are Qualified To Be RESNET Quality Assurance Designees

Complete the information below:

GENERAL INFORMATION

First Name: *

Middle Initial:

Last Name: *

Company/Organization: *

LOCATION

Country: *

Address: *

City: *

State *

Zip *

CONTACT INFORMATION

Phone: *

Email: *

REQUIREMENTS

I have passed the Rater Trainer/QAD Test *

and

I have performed 25 confirmed ratings

I have completed QA Field reviews on a minimum of ten (10) homes and QA File reviews on a minimum of twenty (20) homes under the supervision and mentorship of another Quality Assurance Designee

NAME OF PROVIDER(S) WHO CERTIFIED 25 RATINGS

Provider: *

Provider 2:

Provider 3:

RATING VERIFICATION

QAD Who Verified 5 Ratings: *

Signed Letter from Reviewing QAD: *

Please upload a signed letter from the established, reviewing QAD stating that the QAD candidate has met the minimum requirements of 905.1.1.1.1 OR 905.1.1.1.2

ADDITIONAL NOTES

Notes: